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Mental Health Use this forum to share your mental health concerns and to seek advice.

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Struggling in therapy, in life - January 5th 2021, 12:22 AM

Hi,

I have not made a thread here in a while and was trying to hold off reaching out, trying to do it all on my own.

I am seeing an individual therapist one time a week. She is an intern and works under a supervisor. This is also teletherapy because you know, covid.

In the beginning, around mid October I was seeing her once every 2 weeks because I was feeling nervous about starting over and decided to take it slow. Then I realized I really do need 1x a week so I started doing that sometime in November. And Then the month of December, we did not meet the week of Christmas.

Last time we met was on Monday Dec 21st. We were talking about something that I guess I still have unhealed wounds and I was at first talking very fast and making random jokes and I was also really sniffly because I was starting to have covid symptoms that evening (and I had covid since then and just got out of quarantine on Friday and returned to work today) and then because of the overwhelming topic, I had shut down a bit and was feeling spacey for a few days. During that time I was also feeling very embarrassed and ashamed about shutting down and ashamed about the topic itself and I had told her there was more to it that I was too embarrassed to talk about, so I was feeling embarrassed about what came up in my head that we have not discussed out loud and been anxious about seeing her again leading up to this evening which is the first time since the previous session seeing her. She has not addressed the me shutting down thing and I am not sure if she really knew that that was happening and that is also really anxiety provoking because I don't like when I have to tell a therapist of my symptoms hoping they would agree with me. I have negative experiences with that.

Well, the session went by really fast with me filling her in on things and talking about my difficulty at work. I am a teacher and teacher assistant (sort of both because some subjects I teach and some I assist) We went through the session with me talking about work the whole time and then our time was over and I felt like I have wasted it. She asked me how all the stuff that was going on affected me and I feel like that might have been an imortant question but I tend to need extra think time when it comes to questions about my feelings and I sense that I just didnt give the question enough time and thought and she asked it when there was only one minute left.

I find that I am ranting on a lot of factual details and not speaking much about my feelings towards it or how it affects me. I am not sure it is enough to be asked these questions because I am struggling to go about answering them.

I have been told by therapists in the passed that I am 'insightful' and as hard as it is to take positive words about myself, I will take it. Except I feel like what is sometimes overlooked is that I may be perceptive about what is going on in a situation, factually and in terms of having a balanced view. But in terms of how it impacts me, or naming my feelings or even feeling the feelings, I have a hard time with those kinds of skills.

I would say I blog often enough, I am able to write stream of consciousness kind of writings. But I am getting to a point that I don't know how to do therapy. It is not a matter of simply writing down the things I want to talk about or journaling during the week because I do those things already and naturally incline towards writing things. It is about the topics I do end up bringing up and the topics that get the air time and when I bring up a more buried topic like my past rather than my current work stress, I have difficulty sustaining the conversation. My defenses go up and I either make jokes, find ways to distract and go off topic and/or shut down. Another thing is I dance around the conversations a lot. Like I would not call something abuse, I would say phrases like "did certain hurtful things"

I guess I would find it helpful if she maybe asked me questions in advance and then I would have few days to think about it and answer. It is a weird thing though because we talked about me emailing her out of session and she has certain guidelines including 1 email per a week and that she would not reply to the email, rather she should respond in the next session. Also she said make sure if it is an emergency or if I am in crisis to not use email and call a crisis line instead. And to remember what I put in an email that is not guaranteed confidentiality in terms of potential hacking which i guess is more of something to keep in mind and use my judgement for.

How can I utilize this new email opportunity agreement in the most optimal way? What can I do to talk about the real stuff instead of the work related stuff, which may be important but has a tendency to take up a lot of the talking time and this is not the first therapist this happened with. It is a pattern I noticed. And if I am asked any deeper questions about my work situation, it is not like I am able to carry those conversations because I get the same kind of antsy/silly/shut down as when I am talking about heavy topics. Because I know that my job is a helping profession and working with people and it definitely triggers things in me and that IS actually related to deeper things but we somehow never really get there whichever direction we go.

I know I have not been with this therapist that long but it is about that time that the getting to know you stage is wearing out and I noticed with previous therapists we danced around topics a lot or continued to talk about present day things in a surface-y way and I really want it to be different this time.
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Re: Struggling in therapy, in life - January 5th 2021, 06:34 PM

I think it's worth mentioning the fact that you shut down after the session. I definitely understand your concerns of bringing up how you feel, in hope that a therapist agrees, as I understand that when a therapist disagrees it can feel quite heart-breaking when you have been vulnerable opening up. While therapy can feel difficult at times, I personally don't believe it should leave you feeling shut down/spacey for a few days. When I was in therapy, my counsellor had a way of making sure I was okay at the end of the session and focusing on what to do afterwards to look after myself.

You didn't waste your time talking about work. Though it seems like you were so busy trying to explain things that you didn't have enough time to talk through how you felt. It's also understandable needing extra time to think about how you actually feel. I think this is worth bringing up with your therapist. It can help talking about things, but I wonder if your therapist can perhaps try to help guide you through the session so that you aren't left with only a few minutes to talk about how you feel?

I, too, have been told by therapists that I am insightful. I can provide a lot of personal insight into my thought processes, feelings, actions, and theories about the world around me. But I understand that perhaps because of coming across as insightful, your real struggles are being missed. Do you think it might help to let your therapist know that you realise you are able to talk factually about things, but when it comes to emotions, you struggles to identify your own? Though I can't diagnose as I'm not a professional, it might be possible that you may be experiencing alexithymia- and your therapist might be able to help you with this.

There isn't really a wrong way to do therapy. It's okay if you realise that you don't experience emotions to certain things, but then experience them at other times or that it takes you a while to process what you want to say or that you don't know what to say when asked how you feel about something. Ideally, therapy should take your needs into consideration.

It's good that you are blogging and writing during the week- especially when it's a stream of consciousness. I do this too and have found it quite helpful. I do understand that the topics you want to talk about and the topics you do end up talking about can be quite different. Especially if it's about the past and you feel your defences going up. I'm wondering if your therapist is aware of your defences- making jokes, getting distracted? Perhaps you can ask her to point it out to you when this is happening so that you can stay on track? And if you feel shut down, let her know that you are feeling this way, so that she can work with you to help you recover from being shut down. Is it at all possible to include writing things down during a session, when you are struggling a bit? It seems like writing is a strength to you and perhaps being able to focus by writing when talking about a difficult topic might help a bit? It's also perfectly okay to not refer to something as abuse and instead just say 'hurtful things'. What happened was hurtful towards you, so it doesn't matter whether you use the word 'abuse' or not. Maybe you can try describing what happened rather than using phrases? Of course, if you don't feel ready to talk about things or feel scared/vulnerable for whatever reason, then I understand not wanting to talk about the experiences directly and instead using phrases.

Since you feel it would be helpful, I'm wondering if maybe you could ask your therapist, perhaps at the end of the session, for questions or topic points to talk about in advance of the next session so that you have time to think and prepare? I, too, prefer knowing what to talk about in advance, so I don't believe it's an unreasonable request.

It's good that you have an email opportunity, but I understand that 1 email per week may feel quite limiting. Do you think it might help to email the day/night before your next session? You could use your blogs/writing, and think about what you really want to say and edit it so that's precisely what you want to talk about and not topics that you might get distracted with. You could write in depth about what you want to cover, and then perhaps highlight key words/phrases for specific areas to focus on?

I understand that you've not been with this therapist very long and I don't want to dissuade you, but if you ever consider a new therapist, might it be worth thinking about one that offers email counselling? This might help you as you'll have time to think about what you want to say and time to respond and maybe stay focused on the topic a bit more allowing you to reach the deeper things as opposed to the surface stuff? I know for me, my ideal therapist, would be one that offers such a thing and preferably responds equally in depth

Hope this helps a bit


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Re: Struggling in therapy, in life - January 10th 2021, 11:30 AM

Thank you for your thorough response. I tried the email thing and sent her an email. I guess tomorrow evening will be when we discuss it at session. I have used email with one former therapist in particular and it really helped to have the combination of face to face and email. I have considered 100% email based therapists but then I would miss out on the live interaction and the dedication to spend an interrupted 45 minutes a week on my mental health.

I did start a group art therapy and had 1 session so far. That is something I agreed to commit to for the duration of the weekly sessions for 3 months (until mid April) So im thinking of how to best utilize both sessions to the fullest.

May be in the future I would combine live group therapy and an email based individual therapist.

I also have a hotline organization that I've been emailing, using the chat line and calling every now and then for a few years. I no longer use the phone line because that's for crisis. I occasionally use the Chatline when it is night time and my self harm urges are strong. It is not a 24 hour hot line so that's when I would try to hold on until I can access support. I guess since moving in August to a new city and with covid, a lot of my support network either was lost or changed to online. It has been scattered as well. Sometimes out of the blue a friend would whatsapp me and ask if I want to talk on video call and I 3ould realize that because we haven't spoke in so long, I closed up and don't want her to see me in a distressed state and then i end up isolating unless I'm in a positive mood and then my standards get higher and higher and before I know it in waiting for the perfect mood that I feel worthy enough to let people see me. I can't keep waiting around for the sporadic perfect mood just to feel worthy enough to socialize.


I am going to put together a list of things I'd like to bring up with her based on what you mentioned and email her for the week after about things we can start doing. My fear is that because she is an intern and is in college that I will be bombarding her.

Last edited by NeuroBeautiful; January 10th 2021 at 11:55 AM.
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Re: Struggling in therapy, in life - January 11th 2021, 12:34 AM

Do you ever do anything after your sessions? I struggle a lot after sessions and always have those post-session thoughts. I think a routine of sorts to help feel safe and adjust to the environment outside of therapy could help. I usually write my thoughts and listen to music, or sometimes I sit in silence for a while to absorb things.

You could also draft an email throughout the week and then tweak it before sending it so that the heavier topics are present and the other ones are removed. However, as it's been said, there isn't really a wrong way to do therapy. Other topics, even if they aren't as heavy, are still important because they're a part of your day to day life.

The only other thing that comes to mind is trying to keep a separate space for the topics that aren't as heavy. You can prioritize the heavy ones and give yourself a few minutes at the beginning or end of a session to talk about the smaller things. A lot of people find doing that useful as a way to start and end the session.


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Re: Struggling in therapy, in life - January 31st 2021, 03:17 PM

Quote:
Originally Posted by cynefin View Post
Do you ever do anything after your sessions? I struggle a lot after sessions and always have those post-session thoughts. I think a routine of sorts to help feel safe and adjust to the environment outside of therapy could help. I usually write my thoughts and listen to music, or sometimes I sit in silence for a while to absorb things.

You could also draft an email throughout the week and then tweak it before sending it so that the heavier topics are present and the other ones are removed. However, as it's been said, there isn't really a wrong way to do therapy. Other topics, even if they aren't as heavy, are still important because they're a part of your day to day life.

The only other thing that comes to mind is trying to keep a separate space for the topics that aren't as heavy. You can prioritize the heavy ones and give yourself a few minutes at the beginning or end of a session to talk about the smaller things. A lot of people find doing that useful as a way to start and end the session.

Meant to reply to this sooner and say thank you. I like the idea of prioritising within the email.
I don't have an after therapy routine but I think it would be good to have one. I usually try to get straight to work and finishing up work related things. It would be good for me to slow down on therapy evenings and I can hustle during the other days.
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